Efficacy and safety of the use of autologous plasma rich in platelets for tissue regeneration: a systematic review.
BACKGROUND
Autologous plasma rich in platelets (PRP) is a derived blood product whose application in clinical practice is growing. A systematic review was conducted to evaluate its efficacy and safety.


METHODS
A search was performed in electronic databases. Randomized controlled clinical trials (RCTs) in adult patients were included and assessed for methodologic quality. The main outcomes were "tissue regeneration" and "safety." Relative risks (RRs) and standardized mean differences (SMDs) were calculated to show pooled estimates for these outcomes. When the results heterogeneity was more than 50 percent, a sensitivity analysis was performed.


RESULTS
Twenty RCTs were included (11 of oral and maxillofacial surgery, 7 of chronic skin ulcers, and 2 of surgery wounds). Four RCTs evaluated the depth reduction in gingival recession in chronic periodontitis; the SMD was 0.54 (95% confidence interval [CI], 0.16 to 0.92) mm, favorable to PRP. Three RCTs evaluated the clinical attachment level in chronic periodontitis; the SMD was 0.33 (95% CI, -0.71 to 1.37) mm. Six RCTs assessed the complete skin epithelialization in wound ulcers; the RR was 1.40 (95% CI, 0.85 to 2.31). Only 6 RCTs reported adverse effects without differences between groups.


CONCLUSIONS
PRP improves the gingival recession but not the clinical attachment level in chronic periodontitis. In the complete healing process of chronic skin ulcers, the results are inconclusive. There are little data about PRP safety. There are several methodologic limitations and, consequently, future research should focus on strong and well-designed RCTs that assess the efficacy and safety of PRP.
Martínez-Zapata
Ma José
MJ
Iberoamerican Cochrane Center, Epidemiology and Public Health Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. mmartinezz@santpau.cat
Martí-Carvajal
Arturo
A
Solà
Ivan
I
Bolibar
Ignasi
I
Angel Expósito
José
J
Rodriguez
Luciano
L
García
Joan
J
D001804:Blood Transfusion, Autologous; D002908:Chronic Disease; D055113:Chronic Periodontitis / Q000601:surgery; D006801:Humans; D017713:Platelet Transfusion; D016032:Randomized Controlled Trials as Topic; D012449:Safety; D012883:Skin Ulcer / Q000628:therapy; D013515:Surgery, Oral / Q000379:methods; D014945:Wound Healing